The crisis afflicting NHS Grampian has intensified with the early retirement of chief executive Richard Carey following the resignation of the chairman, Bill Howatson.
There seems to be a breakdown of confidence, morale and trust between senior management and medical practitioners.
It is difficult to determine to what extent underfunding has aggravated staff shortages and the combined effect of both has led to growing problems. Claims by the Scottish Government that funding is not an issue, however, are not credible. The Audit Commission has identified severe underfunding over a number of years. The Institute of Fiscal Studies highlighted recently that while health spending in England has increased in real terms and the extra funding has been passed to the Scottish Government through the Barnett formula, spending has not risen as much in Scotland. Added to that populist policies like abolishing prescription and parking charges have diverted money away from the clinical budget.
Problems of recruitment and retention of key staff have been highlighted for some time now. It has been suggested that consideration should be given to paying an Aberdeen weighting. This would mean an automatic increase in funding to allow for this.
However, given the crisis we are now facing, urgent measures are needed to recruit a new management team and to provide it with the resources to tackle the crisis and address the problems and shortfall. This clearly requires the Scottish Government and NHS Grampian to work together to give not just NHS staff but also patients the confidence the system needs.
Oil and gas needs simpler tax system
As we approach the autumn statement of Government tax and spending plans for the coming year, the oil and gas industry is hoping for solid progress towards recognising the challenges the industry faces.
As we all know tax revenues have been declining with falling production and rising costs. The Government have produced tailor made tax breaks to unlock individual projects and published the Wood Review to encourage co-ordination within the industry and unlock connected discoveries which could otherwise be uneconomic to develop.
As a result we have had a peak in capital investment. Nevertheless, the outlook looks less rosy. A number of companies are reducing their holdings in the North Sea. Redundancies have been announced and more are likely. Given the skills’ shortage across the industry it is likely affected individuals will be re-employed but not without stress and uncertainty.
On top of this, the oil price has been falling from a peak of approaching $120 to a possible $80. For a high cost and mature area like the North Sea this is challenging. Of course the industry had to take steps to put its own house in order with some suppliers facing a margin squeeze. I have been impressed with the way the Government has been able to negotiate with individual companies and stimulate investment. However, we need a simpler, more transparent system if we are to attract investment from other lower cost, simpler tax regimes.
Prescribing GPs and their patients need fair treatment
A court case which had successfully challenged NHS Grampian’s decision to allow GP prescribing for the Methlick and Pitmedden surgeries threatens once again the future of the GP service in Tarves.
Although the provision of prescription is separate from the surgery provision the shared overheads make a difference to this rural practice.
After the original decision was taken to end prescribing at Tarves and Pitmedden, GPs closed the Tarves surgery which was re-opened when Pitmedden prescriptions were re-instated. Now this is up in the air again.
In the middle of a bigger crisis NHS Grampian had opened a very short consultation on the situation. The community council have called for a longer period and I and North East MSP Alison McInnes support this. Our prospective Parliamentary Candidate, Christine Jardine has been able to attend meetings on our behalf.
More importantly we need clearer policy guidelines on community pharmacies and prescribing GPs in rural areas.
I understand and support the improvements community services can provide but these count for little if it weakens the other health service provisions people in rural areas receive - such as access to a GP surgery.
Let us hope we can get a better outcome than the present court decision threatens.